• Andrew Day, Ralph Smith, Iain Jourdan, and Tim Rockall.
• Minimal Access Therapy Training Unit, Postgraduate Medical School, University of Surrey, Guildford, UK. dayandrew@hotmail.co.uk
• Surg Laparosc Endosc Percutan Tech. 2012 Apr 1;22(2):e98-101.

PurposeLaparoscopic colonic resection for cancer is becoming well established within the surgical community. However, the current evidence for laparoscopic total mesorectal excision (TME) is scanty but does point toward a potential for improved short-term outcomes and oncological equivalency to open resection.MethodsPatients undergoing laparoscopic TME for rectal cancer in 1 hospital between October 2003 and December 2010 were analyzed. Data were collated from a prospective database. Survival analysis was calculated using the Kaplan-Meier method.Results79 patients were analyzed (96.3% of all TMEs). There was a median length of stay of 5 days, with no postoperative mortality. The 5-year overall survival was 70% and the 5-year disease-free survival was 65.5%. There was a conversion rate of 10.1%. The 5-year overall survival for completed laparoscopic cases was 70.6% versus 62.5% for converted cases (P=0.041).ConclusionsThere seems to be increasing evidence that laparoscopic TME is equivalent to open TME for rectal cancer. Conversion may be deleterious to overall survival.

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